Early weaning from mechanical ventilation in children will lead to an extubation failure,however,prolonging mechanical ventilation will increase the risk of ventilator associated complication and the economical burden of disease.Nowadays there is no unified and objective ventilator weaning indexes in pediatrics,so it is significant to searching for appropriate and feasible ventilator weaning indexes.This article detailed the current progress on the condition and predictors of ventilator weaning in children,and comparing the predictability and accuracy of ventilator weaning indexes in children,also looking forward to the possibility of higher accuracy or scheme in ventilator weaning that used for clinical purposes.

The retinal vessel changes are the primary and major features of retinal vascular diseases.The retinal vessel is part of systemic vessels with its own characteristics to sustain normal retinal function.These basic characteristics are important to the correct understanding and proper treatment of retinal vascular diseases.Always keep in mind that the retinal vessels is one part of the systemic vascular system,thus retinal vascular diseases may have systemic etiology,and systemic drug administration may have a profound effects to the whole body.However retinal vascular system also has its own structural and functional characteristics,thus retinal vascular diseases are also different from the systemic diseases.Finally the main function of retinal vascular network is to maintain the neuro-retinal function,thus we should balance the vision protection and treatments against abnormal retinal blood vessels.Over-treatments may damage the retinal vision.

The paper gives a detailed description of the main features of American medical services,the characteristics of American hospitals,the responsibilities of hospital presidents and the problems faced by them.In addition,it introduces the macro-management of American hospitals and the existing problems.

Objective To evaluate the application value of ultrasound-guided minimally invasive stereotactic breast excision in the diagnosis and treatment of breast mass. Methods The minimally invasive operations for 218 patients were performed by ultrasound-guided Mammotome system, and the therapeutic efficacy of Mammotome system was evaluated. Results All the patients were completely excised by the Mammotome system. No failed procedure occurred,all the masses were pathologically confirmed as benign lesions in 214 patients and invasive ductal carcinomas in 4 patients. Postoperatively, the incision scar was barely visible and no complications happened except for mild subcutaneous hemorrhage in 9 patients,local hematoma in 3 patients and local deep pitting of the skin in 5 patients. Conclusion Mammotome system shows many benefits with less trauma, more rapid recovery and with less complications.

Objective To investigate the clinical effects of enalapril combined with atorvastatin in the treatment of diabetic nephropathy .Methods 108 patients with diabetic nephropathy from August 2014 to August 2016 were selected and randomly divided into the observation group and the control group, 54 cases in each group.The control group were treated with enalapril based on the conventional diabetes treatment, and the observation group were treated with atorvastatin based on the control group, the changes of FPG, 2 hPG, HbAlc, SBP, DBP, UAER, SCr and Ccr were observed and compared between the two groups.Results After treatment, the control group and the observation group patients with diabetes indicators FPG, 2 hPG and HbAlc in the control group, were significantly lower than before treatment, the difference was statistically significant (P <0.05), but there was no statistically significant difference between the two groups after treatment.The control group and the observation group patients with diabetic nephropathy , SBP, DBP, UAER, Scr, Ccr were significantly lower than before treatment, the difference was statistically significant (P<0.05), and after treatment, UAER, Scr and Ccr in the observation group were significantly lower than those in the control group, the difference was statistically significant ( P<0.05).Conclusion Enalapril combined with atorvastatin can effectively delay the progression of the disease, protect renal function based on good control of blood glucose in the treatment of diabetic nephropathy.

OBJECTIVE: To observe the effects of combined application of Radix Salviae Miltiorrhizae injection and dopamine injection on peritoneal dialysis patients.METHODS: By self-control method,the peritoneal dialysis solution of 22 patients with ambulant continued peritoneal dialysis was added with 20 mg dopamine injection and 12 mL Radix Salviae Miltiorrhizae injection for dialysis of 14 days.The D/P values of urea nitrogen(UN) and creatinine(Cr),week's peritoneal UN clearance index(KT/V),the clearance rate of Cr(Ccr),week's total KT/V,Ccr,reabsorption rate of glucose and the net amount of 24 hours' ultrafiltration were recorded before and after medication.RESULTS: The addition of dopamine injection and Radix Salviae Miltiorrhizae injection to the peritoneal dialysis solution resulted in significant higher values in week's peritoneal KT/V,Ccr and week's total KT/V,Ccr and the net amount of 24 hours' ultrafiltration as compared with before medication(P

OBJECTIVE: To study the clinical pharmacokinetics of traditional Chinese medicine(TCM) for reference of clinical rational drug use.METHODS: The status quo of the pharmacokinetics and clinical pharmacy of TCM was analyzed and the perspectives on the prospects of clinical pharmacokinetic of TCM were put forward.RESULTS & CONCLUSION: The research on clinical pharmacokinetics of TCM is of great significance in that it can provide quantified data and evidences for clinical rational drug use.

Private Hospitals are lawful medical institutions which are responsible for their own management decisions,profits and losses.They aim at making profits but also pay much attention to the unification of social benefit and economic benefit.Taking the Shanghai Private Hospitals as an example,by data collection,questionnaire survey and interviews from general public and hospital administrators,it is concluded the overall development of Shanghai Private Hospitals is far from satisfaction.Private Hospitals must define their medical concepts and market orientation for long-term development,and strengthen the monitoring system and attain public′s trust for their healthy development.Since China has a huge demand for medical service,private hospitals will surely have a bright future as long as capturing the market and holding the faith of "serving for patients,and benefiting the society".

With the development of science and technology,especially the development of medical technology,human beings have an increasing power in controlling their life and their reproduction.As a means of self intervention,reproductive technology on the one hand can solve some infertility problems and achieve the objective of aristogenesis,but on the other hand has also brought relevant problems related to rights,obligations, ethics,family and social issues.How do we weigh these complicated problems in the intersection of ethics and science.'? This paper aims to find a balancing point through relevant discussions and consultations to achieve the common development of science and ethics.

OBJECTIVE:To study the pharmacological actions of compound Yinshen granules(CYSG) on cerebral ischemia injuries in rats METHODS:Using an established middle cerebral artery occlusion(MCAO)model devised by Tamura,we observed infarction areas of the brain and behaviour grade of cerebral apoplexy,and calculated brain water content and brain index RESULTS:CYSG(10 0g/kg,5 0g/kg in rats)significantly reduced infarction areas,ameliorated neurological symptoms,decreased brain water content and brain index after MCAO in rats CONCLUSION:CYSG can protect ischemia cerebral injuries in rats